The problem with 10,000 steps a day

morning strollIt’s recommended that we take 10,000 steps a day. However, a recent study conducted at Stanford University found that the global average for steps taken per day is 4,961. Though the UK’s average is above this stat, it’s a far cry from the suggested amount.

But the 10,000 steps figure is not based on science in any case. It originated in a Japanese marketing campaign for a new step counter in the 1960s. Most people find it hard to do 10,000 steps in a day anyway. The good news is you don’t have to. You can get even better benefits from a less arduous programme.

Research shows that three 10 minute brisk bouts of walking a day will achieve the aim of getting your heart beating faster which reduces the risk of diabetes, cardiovascular disease and some cancers. It will also help with back pain. You should aim to walk fast enough to be out of breath enough so you can’t sing but can still talk.

Walking has many benefits, besides reducing the risk of heart disease and back pain it can help you sleep easy! Where you can, swap walking on pavements for paths in green spaces or along the seafront, you’re likely to improve your mood, get the creative juices flowing and reduce feelings of depression. With so many lovely green areas and the coast in and around Brighton and Hove, a little change in your daily routine can do wonders for your wellbeing!

A good walking technique is key to ensure your back is properly supported. Tighten your stomach muscles to engage your core and support your entire body weight. Spinal alignment is vital; try to stand up straight and keep your chin parallel to the ground. Let your arms swing naturally and roll through your foot from heel to toe.

It’s also a good idea to shorten your strides; this will reduce the strain on your knees, calves and shins. Make sure you get the right technique as you start off so that bad habits don’t develop! Getting the right footwear is key to ensuring you establish a good walking method. When buying shoes you’re going to walk in make sure you go at the end of the day as your feet will be a little swollen meaning you’ll purchase the right size. It’s important that your toes have room to move and that your heel doesn’t slip. This will give you ample support both in your ankle and further up in your lower back.

Try incorporating a walk into your daily routine. By releasing endorphins and boosting vitamin D levels, walking’s benefits will leave you feeling refreshed and energized as well as strengthening your core and back muscles.

As part of your next appointment, we can measure your foot size so that you can get the correct sized walking shoes.

Little-known cause of back pain starts in childhood and is entirely preventable

Back pain often comes on apparently without reason. In fact, one possible cause might stretch all the way back to childhood. Hove dentist, Pieter Grobbelaar, tell us how teeth and jaw problems can be behind chronic pain.

The jaw joint (TMJ) and pelvic joints (sacro-iliac joints) both work in conjunction with one another, compensating for one another when either joint becomes misaligned writes Pieter Grobbelaar. With an abnormal bite the TMJ becomes dysfunctional and this creates instability at the weight bearing sacro-iliac joint in the pelvis. This leads to poor body posture which can cause low back pain, neck pain, headaches and other health problems.

The majority of children (75%) now have crooked teeth, incorrect jaw development and other orthodontic problems, which is evident from 3-5years of age, are not caused by big teeth in small jaws or hereditary factors. However, rather than blame genetics for crooked teeth and poor jaw development, modern research has produced evidence that points to other causes.

Concordia dental healthcare has recognised that Soft Tissue Dysfunction or poor myofunctional habits such as mouth breathing, incorrect tongue position, reverse swallowing and thumb sucking are the real causes of malocclusion and poor cranio-facial development.

The restricted development limits the space available for erupting teeth and prevents them from emerging into their natural position.

75% of growing children are affected and most commonly will presents with crooked teeth, undeveloped facial and jaw bones, TMJ (Temporomandibular joint) dysfunction and poor body posture.

Mouth breathing is abnormal and is one of the causes of Sleep Disorder Breathing (SDB) problems.

SDB in children has been recognised as causing widespread health, developmental and behavioural problems, including snoring, gasping, cessation of breathing such as Obstructive Sleep Apnoea (OSA) and interrupted sleep, which can result in drowsiness during the day as well as behavioural problems in children. Additionally, as well as being detrimental to the development of the face, jaws and teeth, if left untreated paediatric SDB can lead to significant and serious health problems causing poor quality of life later in adulthood.

If a child breathes through their mouth during the day or while sleeping at night, the tongue drops to the bottom of the mouth, which results in upper and lower jaw development problems. Allergies, asthma and open mouth posture also cause the jaws to develop incorrectly.

Incorrect dental and facial development can be detected at an early age, but so often no treatment is recommended. It is well known that the majority of our children do not develop their jaws and face correctly. This results in crowded teeth and underdeveloped faces.

Braces and extracting teeth in teenage years does not solve the underlying problems behind the causes of crooked teeth and incorrect facial development.

The balanced cranium provides the anchor points for the tension membranes which support the brain. The rhythmic pulsing of the brain as it expands and contracts, when breathing, provides the basis for the sacro-occipital pump which circulates cerebo-spinal fluid.

One of the most important aspects of normal cranial function is the position of the jaw. When the lower jaw (Mandible) comes in contact with the upper jaw (Maxilla) the movement should be symmetrical, simultaneous and even. This constitutes normal cranio-dental function. When the jaw becomes distorted the entire balance of the cranium is put in jeopardy.

A misaligned jaw will change the bite plane and ultimately the bite, affecting the cranium, TMJ, muscle balance, normal spinal mechanics and pelvic stability.

Good cranial development is needed for optimum neurological development.

The cranium consists of 28 bones, any distortion will affect transmission within the brain, cranial nerves and ultimately the nervous system.

Cranial development is 65% completed at age 8 years and 95% completed at 12 years of age, therefore it’s essential that intervention occurs as early as possible assisting cranial development to its optimum genetic potential.

Pieter-Grobbellar

 

 

Dr Pieter Grobbelaar BChD

Founder and Principal Dentist of Concordia Dental,

51-53 Church Road Hove

 

 

Exercise mistakes that make your back worse

Most back exercises are great for the back and it doesn’t seem to matter much what exercises you do as long as you stay active. But some exercises can be harmful and actually damage your back. So whether you like the gym, Pilates, yoga or a sport it is important to know the good and the bad. Matthew was recently interviewed about just this topic by Stu Girling from Love Yoga Anatomy. Stu trains yoga teachers and practitioners on safe ways to do yoga.

One of the exercises that does more harm than good is forward bending despite the fact that lots of people do it to stretch their back. As we bend forward huge pressure builds on the lower discs. As you bend from the waist, if the lumbar spine is held in neutral, with its natural forward curve, the pressure on the disc is reduced. If you round your lower back as you bend forwards then the discs are vulnerable. The jelly inside the disc gets forced backwards and can cause cracking in the outer disc wall. If this carries on it can cause a disc bulge or a “slipped disc”.

 

Forward-bending
Lumbar-loads

 

If you bend, as in a yoga forward fold, over and over again then it can cause injury. It is like repeatedly bending a credit card, a white line appears and ultimately it breaks.

Many people with back pain feel that their back is too stiff and want to stretch it. A better goal for exercises is the right mix of flexibility and stability. If your back is too stiff and this causing pain then the solution is to unlock the spinal joints with chiropractic manipulation or mobilisation. If, however, your problem is too much flexibility then we work to stabilise your spine.

Surprising facts about back pain and arthritis of the spine

Brighton chiropractor, back painBack pain is surrounded by myths which often cloud simple facts. People with back pain are often told is that “it is just wear-and-tear and you’ll have to put up with it” or “it’s probably arthritis. What do you expect at your age”. This is not very helpful and often is plain wrong.

Many back sufferers are unclear if it is arthritis or not and what the best treatments and self-help strategies are. The surprising news is that arthritis is not as important as a cause of back pain as we once thought.

 

 

What is arthritis of the spine?

When people say arthritis of the spine they are mainly talking about osteoarthritis. This is the most common sort and occurs in almost everyone as we get older. There are characteristic changes to the discs, vertebrae and spinal joints. The first sign on an X-ray or MRI scan is a loss of fluid from the jelly in the centre of the discs, especially of the lower lumbar spine. The discs then lose height and in the advanced stages can almost disappear. This is why we get shorter as we get older. The spine responds to these changes by growing bony spurs to buttress the ageing discs which give the spine a bumpy shape on X-ray and other imaging. The discs in the lower back carry the most load so this is probably why they have these changes first.

The spinal joints are prone to osteoarthritis too. First the non-slip surface of the cartilage covering the bones gets roughened and pitted as it wears a bit. The joint may make more noise as it moves so you may hear more clicks and crunching sounds. Sometimes it sounds like grit in the joint although this is rarely painful. In the advanced stages extra bone growth occurs here too and this can be seen as bony spurs on imaging. The range of movement of the joint decreases and this leads to loss of flexibility as we get older. 

Arthritis does not cause more back pain

The good news is that as horrible as these changes appear they have not been shown to cause an increase in back pain. Imaging of people with back pain shows that they have the same levels of osteoarthritis in the back as people of the same age without back pain. So what is going on?

It is likely that arthritis in the spine does not cause pain directly. It may, however, make it more likely that spinal joints will lock up and this can cause pain. As locking of the spinal joints is a common cause of back – so-called facet joint syndrome- it seems that the effect of osteoarthritis is lost in the frequently occurring condition. Spinal manipulation and mobilisation by our chiropractors and physiotherapists unlock the joints that cause the pain and is an effective treatment for most back pain.

There is one a rare side effect of osteoarthritis where the bony spurs get so big that they press on the nerves. If they press on the nerves that go down the leg it can cause sciatica symptoms. If compression occurs around the spinal cord this can cause a condition called spinal stenosis. Then pain and numbness can occur in both legs especially after walking a short distance. Manual treatment and exercises can help but surgery is rare but sometimes necessary.

In addition to osteoarthritis there are many other sorts of arthritis. This includes rheumatoid arthritis which is an aggressive, auto-immune disease in which inflammatory changes attack the spine and other joints. Fortunately it is an unlikely cause of back pain. The other significant but also rare form of spinal arthritis is ankylosing spondylitis. This is also an inflammatory disease which is more common in men and causes progressive spinal stiffness and pain. Both rheumatoid arthritis and ankylosing spondylitis are diagnosed with a blood test and can be treated with medication. If we think you may have this sort of condition we will refer you back to your GP. 

If you would like a free consultation to find out if arthritis might be contributing to your back pain then give us a call or book online above.

Reference

Facet joint osteoarthritis and low back pain in the community-based population.

Kalichman L1, Li L, Kim DH, Guermazi A, Berkin V, O’Donnell CJ, Hoffmann U, Cole R, Hunter DJ.

Spine (Phila Pa 1976). 2008 Nov 1;33(23):2560-5. doi: 10.1097/BRS.0b013e318184ef95.

https://www.ncbi.nlm.nih.gov/pubmed/18923337

Why an accurate back pain diagnosis is essential

Back pain is not one condition but several conditions causing similar symptoms. A muscle spasm, disc derangement and a spinal joint dysfunction all cause low back problems that can refer pain down to the buttock and leg and a skilled chiropractor or physio can tell which problem it is likely to be. Whilst several conditions can co-exist an accurate diagnosis is important because the treatment is different for all three.

The diagnostic confusion is made worse by the different experts who treat back pain because they often use different terminology to describe the same thing, recommend different treatment based on their area of expertise and frequently ignore the evidence that their approach has been shown to be ineffective and so leave you, the patient, in pain and more confused about what is wrong.

Most back pain is caused by irritation to:

  1. joints,
  2. discs,
  3. muscles or
  4. nerves of the spine.

This irritation happens with repetitive minor trauma such as bending and lifting or, more rarely, by a single traumatic injury such as a fall or accident. It can also be caused by inactivity which causes the joints of the spine to stiffen up and the back support muscles to become weak such as sitting at a desk for long periods.

If the joints of the lower back get stiff they are less able to carry out normal movements and this can lead to further joint irritation, stiffness and pain. This is often called Facet Joint Syndrome. The nerves around the stiff joints get irritated too and fire off alarm signals into the nervous system which can cause further symptoms such as tingling and pain referred down to the hips and legs. This can mimic sciatica.

Occasionally, the nerve irritation can cause muscles in the legs to weaken and this can lead to problems in the hips and knees. How this occurs isn’t clear but anyone with hip or knee problems seeing us here at Sundial will get a thorough muscle and spine check-up.

We treat back pain with an effective step by step programme to rebuild strong and healthy backs so you can lead an active and fulfilling life.

 

Get started today with a free consultation…

Book now

 

 

Bare as you dare – how sunbathing prevents back pain

The sun is shining; it’s warmed up; time to take your clothes off!

If you are suffering from ongoing back pain, then you could be deficient in Vitamin D. This hormone is responsible for a wide range of processes in the body including bone and muscle function. A commonly missed cause of back pain is Vitamin D deficiency, especially over a long winter. At least 50% of people in the UK show signs of vitamin D deficiency and many will have increased back pain as a result.

Common signs of vitamin D deficiency

  • muscle and bone aching
  • pain sensitisation, lower pain threshold
  • fatigue
  • depression
  • weakness
  • muscle soreness after exercise

Vitamin D is essential for bone formation as it helps your body absorb calcium from food. If you don’t have enough Vitamin D you can get a condition called osteomalacia. The dull, aching pain associated with osteomalacia most commonly affects the lower back, pelvis, hips, legs and ribs. This pain can be worse at night, or when you’re weight bearing. Vitamin D deficiency may cause morning back pain in some people too.

How much Vitamin D is enough?

There are various ideas about what the minimum blood levels for Vitamin D are required. This is a measure in nanomoles per litre of blood (nmol/L). Severe deficiency is anything below 25nmol/L, but anyone below 50nmol/L is considered deficient. Optimum health is often thought of a being above 85 nmol/L although more than 125nmol/L can be required for some people.

How can you get enough Vitamin D?

Fortunately, it is easy to get enough Vitamin D for free as you make it in your skin. Sunlight contains ultraviolet (UVB) rays that stimulate Vitamin D production. UVB rays also cause sunburn, however, so it is important to avoid over-exposure. If you cover up or use sunscreen, you will not produce Vitamin D so only aim for short exposure.

A sensible approach is to aim for 10-30 minutes exposure on as much bare skin as you dare, depending on how sensitive your skin is, several times a week when the sun is strong enough; in the UK that is from April to September. Full body sun exposure with no sunscreen will produce up to 20,000iu (500 μg) in 30 minutes. More importantly, once you have made enough Vitamin D your skin stops producing it so you can’t get too much.

Vitamin D supplements

Over the winter or for if you are severely deficient then supplements are the only way to go. In your diet oily fish such as salmon, mackerel and sardines provide some vitamin D but you would, for example, need to eat 20 tins of salmon a day to get 5000iu.

Here at Sundial we recommend a liquid Vitamin D supplement which is highly absorbable and inexpensive. The chewable calcium based supplements from ordinary shops are often too low in Vitamin D to help much.

Summary

  • Vitamin D deficiency is common and can cause back pain
  • Safe sun exposure on bare skin from April to September is beneficial
  • Taking a good quality supplement over the winter prevents deficiency

For more information and references:

https://www.nhs.uk/live-well/healthy-body/how-to-get-vitamin-d-from-sunlight/

https://www.skincancer.org/prevention/uva-and-uvb

https://www.hsph.harvard.edu/nutritionsource/vitamins/vitamin-d/#new-vitamin-d-research

https://www.healthline.com/nutrition/9-foods-high-in-vitamin-d#section2

 

Can arthritis of the spine cause back pain?

Does arthritis, specifically osteoarthritis, cause low back pain? In this video Brighton chiropractor and back pain expert, Matthew Bennett, reveals the answer and explains what osteoarthritis of the spine actually looks like.

New study slams medical treatment for back pain

backsA new study on back pain in the prestigious medical journal, the Lancet, roundly criticises medical treat of low back pain. Researchers from all over the world took part and looked at how back pain is treated and they concluded that there is “inappropriately high use of imaging, rest, opioids, spinal injections, and surgery.”  They go on to say that “Doing more of the same will not reduce back-related disability or its long-term consequences.”

Back pain is now the number one cause of disability globally and rates have continued to rise in spite of increased spending on treatment. The authors make a plea for more sense and evidence based treatment. They call for a new direction which encompasses emerging treatments alongside effective solutions that exist already.

Effective treatment for back pain

Guidelines exist for doctors to follow on the most effective sorts of treatment but often these are ignored or not implemented properly. Here in the UK, NICE has issued guidelines and these are mentioned in this study as being helpful and they echo the findings in this paper.  The evidence points to a biopsychosocial model of care which looks at the behavioural, psychological, and social factors as well as the anatomical structures which play a role in the persistence of pain and disability. What does this mean for you if you have back pain?

It means that there is greater emphasis on self-management, physical and psychological therapies, and some forms of complementary medicine, and less emphasis on pharmacological and surgical treatments. So staying active, doing gentle exercises, getting some manual therapy as well dealing with stress, anxiety and depression, especially negative feelings around pain and disability, are very helpful. Some guidelines also recommend massage and acupuncture. One thing the guidelines in the US Denmark and UK agree on is that spinal manipulation is helpful. Which is good news because that’s what we do here at Sundial.

The report goes on to highlight the differences in standards of care throughout the world and it is clear that there is huge variance in practise and approach. For instance in the USA only half of back sufferers are prescribed exercises and in Sweden, USA and Australia electrical modalities like ultrasound are routinely used in spite of being ineffective.

Back pain is not one condition

This review is an excellent summary of the worldwide management of low back pain but has its limitations. Back pain is not one condition but several conditions causing a similar group of symptoms. A muscle spasm, disc derangement and a spinal joint dysfunction all cause low back that can refer pain down to the buttock and leg and a skilled clinician can tell which problem it is likely to be. Whilst several conditions can co-exist it is clear that an accurate diagnosis is important because the treatment is different for all three. Here at Sundial we make sure we make an accurate diagnosis and agree a treatment plan that is the most likely to get the best results.

If you would like a free check up to see if we can help your back pain please give us a call or book online above

 

Reference:

Prevention and treatment of low back pain: evidence, challenges, and promising directions

Foster, Nadine EBuchbinder, Rachelle et al.
The Lancet , Volume 0 , Issue 0 ,

21 March 2018

Free physio exercise routine (worth £42) with free spinal check-up

Low back stretchMost people think that having a healthy back is matter of luck, a matter of avoiding accidental injury and bending a lifting properly. Whilst these things certainly help there are three things that research has shown to be the most effective way of treating and preventing back pain.

Firstly, and most importantly, keeping fit and active has the biggest impact on preventing back problems. Initially, a few days rest may help a bad back but getting active early on is key to a full recovery. Once your back is better it is important to maintain levels of activity and there are certain simple exercises that you can do at home. These exercises can also prevent back pain coming on in the first place.

The second thing that will help keep your back in tip top condition is getting treatment sooner rather than later. If back problems are not clearing up or keep coming and going it may be a sign that that the condition is slowly worsening and this can lead to chronic, ongoing pain.

The third solution to keep your back healthy is regular preventative check-ups. Back problems come on because the spinal joints gradually stiffen over time, causing reduced movement, inflammation and pain. We can check for the early signs of spinal stiffness and our treatment can unlock the stiff joints and prevent the pain from coming on in the first place.

For January, we are offering a free spinal check-up with a chiropractor combined with free 30-minute physio assessment and personalised exercise routine (worth £42) for everyone seeing a Sundial chiropractor. To book in online – www.sundialclinics.co.uk or call Sundial Queens Road, 01273 774114

 

Terms and conditions: One free spinal check up and one free physiotherapy exercise session is available on request. To be eligible to claim you must receive a session with a Sundial chiropractor between 2nd – 3rd February 2018. Only one free chiropractic check-up and one free physiotherapy session is allowed per person and it must be taken by 31st March 2018. The free sessions are not transferable and cannot be exchanged for the cash equivalent. 

Preventing low back pain

low back treatment, chiropractor BrightonRecent research shows that low back pain can be prevented with regular chiropractic care. Researchers from the Karolinska Institute in Sweden reported that early results from their randomised control trial showed significant improvements in the recurrence of back pain. These results, as yet unpublished, were reported at the latest European Chiropractic Union Conference in Cyprus, May 2017.

In the trial, people with recurrent low back pain were divided into two groups. Both groups were treated with an initial course of usual chiropractic care which consisted of spinal manipulation, mobilisation, exercises and advice. One group was then told to come back every few months and the other group was told to come back only if and when the pain recurred.

The group that were told to come back every few months experienced nearly 20 fewer pain days over the year.  On average they had two more treatment visits than the other group.

This result confirms for the first time that regular chiropractic care can have a significant influence on the course of low back pain. People with recurrent episodes of back pain should consider regular preventative check ups to reduce the impact of their back pain.

Here at Sundial we recommend periodic check ups every few months based on your history and the severity of the problem. We monitor progress through regular reassessments and online questionnaires to help us improve our care.